BEFORE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SHIMLA, H.P.
Consumer Complaint No: 8/2009
Date of presentation: 19.12.2008
Date of decision: 23.03.2011
Attar Singh S/O Shri Ram Singh,
Resident of Village Kather,
Near HP State Electricity Board, Sub Division
Post Office Chambaghat, District Solan, H.P.
… Complainant.
Versus
1. Reliance General Insurance,
Regional Office SCO 212-214, Sector 34-A,
Chandigarh-160022
Through its Senir Manager.
2. Branch Manager,
Reliance General Insurance Company Ltd.,
Rain Basera Building, Khalini, Shimla, H.P.
3. Principal,
Government Polytechnic (Women),
Kandaghat, District Solan, H.P.
…. Opposite parties.
For the complainant: Shri M.L. Sharma, Advocate.
For the Opposite Party No.1&2: Shri Suryadeep Thakur, Advocate vice
Shri Chanden Goel, Advocate.
For the Opposite Party No.3: Shri Anoop Shama, A.D.A.
O R D E R:
R.L. Azad (District Judge) President:- Case of the complainant in brief is that his wife Smt. Kamlesh Kumari was working as Sweeperess with the OP No.3. On 01.11.2007, she was travelling in bus No.HP-14-2149 from Solan to Kandaghat, which met with an accident near IPH Office Kandaghat, as a result of which she died due to fracture skull causing brain injury. The matter was reported to the Police upon which FIR was lodged with the concerned police station. The deceased wife of the complainant was insured with the OPs No.1 & 2 under ‘Group Personal Accident Scheme’ which was valid from 01.11.2006 to 01.11.2008. A sum of `50/- was being deducted from her salary by the OP No.3. The OP No.3 on receipt of the requisite documents lodged the claim with the OPs No.1 & 2, who instead of settling the claim rejected the same vide letter dated 22.10.2008 on the sole ground that the intimation regarding death of the deceased was not given to the OPs No.1 & 2 well in time, hence, denied the liability. The complainant alleged that the act of the OPs No.1 & 2 in not entertaining the claim of the complainant is illegal, wrong and arbitrary and are liable to indemnify the complainant for the insured sum of `2,00,000/- along with damages of `20,000/- and litigation expenses. Hence, the complainant was forced to file this complaint under section 12 of the Consumer Protection Act 1986.
2. The OPs No.1 & 2-Company filed reply and contested the complaint on the ground that the claim was not lodged within 30 days of occurrence of accident. It is contended that the deceased died on 01.11.2007, whereas, the intimation was given after lapse of 10 months, i.e. on 30.08.2008, as such, the OPs No.1 & 2 have been deprived of its valuable legal right of getting the case investigated. Hence, the claim was rightly repudiated vide letter dated 22.10.2008.
The OP No.3 in its separate reply has contended that no cause of action had accrued against it, as the premium of `50/- was duly deposited with the OPs No.1 & 2. It is admitted that the deceased was insured with the OPs No.1 & 2. It is admitted that the deceased died on 01.11.2007. It is admitted that after receipt of the requisite documents, the claim was forwarded to the OPs No.1 & 2 vide letter dated 30.08.2008, who rejected the claim of the complainant.
3. We have heard arguments of the Learned Counsel for the parties and also perused the documents tendered in evidence by the parties.
4. It is admitted case of the parties that the deceased Smt. Kamlesh Kumari was working as Sweeperess with the OP No.3. It is also not in dispute that the deceased Kamlesh Kumari was insured with the OPs No.1 & 2 under Group Personal Accident Scheme. The deduction of premium amount of `50/- from the salary of the deceased by the OP No.3 is also not in dispute. The death of the deceased during the subsistence of the insurance policy is also not in dispute.
5. Annexure C-3 is the copy of Notification dated 10th October, 2007 issued by Secretary (Finance) to the Government of Himachal Pradesh. Its perusal reveals that the Group Personal Accident Insurance Scheme was renewed for Regular, Adhoc, Part-time, Contractual and daily wages Employees of Government Departments, Boards, Corporations, Universities and autonomous bodies on compulsory basis for a period of one year w.e.f. 10.10.2007. The scheme was implemented through Reliance General Insurance Company Limited, vide which benefit in case of death was `2,00,000/-. The perusal of aforesaid Notification further reveals that ‘the Head of Departments will lodge the claims with the Insurance Company within 30 days of occurrence of any accident in the specified forms’. Therefore, it was not only incumbent, but obligatory on the part of the OP No.3 to have lodged the claim with the OPs No.1 & 2 being the Head of Department of the deceased, under whom she was working as Sweeperess.
6. In the case in hand, the deceased met with an accident on 01.11.2007, whereas, the OP No.3 had lodged the claim with the OPs No.1 & 2 vide letter Annexure R3-E dated 30.08.2008, after a lapse of 10 months. The OPs No.1 & 2, in our view, has rightly treated the claim as ‘no claim’ as the claim was not lodged within thirty days of occurrence of accident. Therefore, the OP No.3 cannot shun its responsibility by not having obeyed the Notification dated 10th October, 2007. Had the OP No.3 lodged the claim with the OPs No.1 & 2 well in time as per the Notification aforesaid, its responsibility would have ceased there and then, but the OP No.3 took more-than 10 months for lodging the claim with the Insurance Company, for which the OP No.3 cannot avoid its liability.
7. In view of the aforesaid, it is clear cut case of a deficiency in service as well as an unfair trade practice having been adopted by the OP No.3 in not promptly lodging the insurance claim of the deceased Kamlesh Kumari, with the OPs No.1 & 2 and thereby depriving the legal heir of the deceased from getting the indemnification amount. Consequently, the OP No.3 is held liable to indemnify the legal heir of the deceased to the extent of `2,00,000/- along with interest and litigation expenses. The OPs No.1 & 2, in our view, cannot be held liable for any deficiency in service.
8. As a sequel to above, we allow this complaint and direct the OP No.3 to indemnify the complainant to the extent of `2,00,000/- along with interest at the rate of 9% per annum, with effect from the date of filing of the complaint. The litigation cost is quantified at Rs.3500/-. This order shall be complied with by the OP No.3 within a period of forty five days, after the date of receipt of copy of this order. The learned counsel for the parties undertook to collect the certified copy of this order from the office, free of cost, as per rules. The file after due completion, be consigned to record room.
Announced on this, the 23rd day of March, 2011.
(R.L. Azad)
President.
NMehta) (Charanjit Singh)
Member.